Endoscopy 2020; 52(S 01): S95-S96
DOI: 10.1055/s-0040-1704290
ESGE Days 2020 oral presentations
Friday, April 24, 2020 11:00-13:00 Endoscopist: RIP! - New diagnostics Wicklow Meeting Room 1 in upper GI endoscopy
© Georg Thieme Verlag KG Stuttgart · New York

WATS3D FOR THE DETECTION OF HIGH GRADE DYSPLASIA AND ADENOCARCINOMA IN BARRETT: EUROPEAN MULTI-CENTER, PROSPECTIVE, RANDOMIZED, TANDEM STUDY

R Bisschops
1   University Hospitals Leuven, Gastroenterology and Hepatology, Leuven, Belgium
,
R Haidry
2   University College London Hospital, Gastroenterology, London, United Kingdom
,
H Messmann
3   Clinic Augsburg III, Gastroenterology, Augsburg, Germany
,
K Ragunath
4   Nottingham University Hospital Queen’s Medical Centre, Gastroenterology, Nottingham, United Kingdom
,
P Bhandari
5   Queen Alexandra Hospital Solent Centre for Digestive Diseases, Gastroenterology, Portsmaouth, United Kingdom
,
A Repici
6   Humanitas Research Hospital & Humanitas University, Gastroenterology, Milano, Italy
,
M Munoz-Navas
7   Universidad de Navarra, Gastroenterology, Navarra, Spain
,
S Seewald
8   Clinic Hirslanden GastroZentrumHirslanden, Gastroenterology, Zürich, Switzerland
,
A Lemmers
9   Erasme University Hospital, Université Libre de Brussels, Gastroenterology, Brussels, Belgium
,
A Castells
10   Hospital Clinic of Barcelona, Gastroenterology, Barcelona, Spain
,
O Pech
11   Krankenhaus Barmherzige Brüder Regensburg, Klinik für Gastroenterologie und interventionelle Endoskopie 46.23, Gastroenterology, Regensburg, Germany
,
E Schoon
12   Catharina Hospital, Gastroenterology and Hepatology, Eindhoven, Netherlands
,
R Kariv
13   Tel Aviv Sourasky Medical Center, Gastroenterology, Tel Aviv, Israel
,
H Neuhaus
14   University of Düsseldorf Evangelisches Krankenhaus Düsseldorf, Gastroenterology and Hepatology, Düsseldorf, Germany
,
B Weusten
15   Antonius Hospital, Gastroenterology and Hepatology, Nieuwegein, Netherlands
,
P Siersema
16   Raboud UMC, Gastroenterology and Hepatology, Nijmegen, Netherlands
,
L Correale
17   Nuovo Regina Margherita Hospital, Gastroenterology, Rome, Italy
,
F Fromowitz
18   CdX Diagnostics, Suffern, U S A
,
GD Hertogh
19   University Hospitals Leuven, Pathology, Leuven, Belgium
,
J Bergman
20   Academic Medical Center Amsterdam, Gastroenterology and Hepatology, Amsterdam, Netherlands
,
C Hassan
17   Nuovo Regina Margherita Hospital, Gastroenterology, Rome, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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    Aims To compare the independent additional yield for HGD/EACs diagnosis resulting from WATS versus 4 quadrant random forceps biopsy (RFB) in a multicenter setting.

    Methods Patients with known BEdysplasia following resection of visible lesions scheduled for ablation therapy at 15 European centers were 1:1 randomized to WATS followed by RFB or vice versa. All WATs were examined with computer assistance by an experienced pathologist (FF) at CDx; all RFBs were examined by a single expert pathologist (GD), blinded to clinical information. Primary endpoints were the detection rate of HGD/AC and the incremental detection attributable to WATS over RFB. Secondary endpoints were detection rate of HGD/AC for the two procedures in combination, detection rate of HGD/AC according to the order of WATS sample acquisition (i.e., before or after RFB acquisition) and procedural times.

    Results 147 patients (male/female, 123/24; mean age, 68.4 years) were included. Overall, we found 49 HGD/EAC cases. Of these, 25 were detected with both modalities, 14 were detected solely by WATS but missed by RFB and 10 solely by RFB but missed by WATS. The detection rate of HGD/EACs did not differ between WATS (39/147) and RFB (35/147) (26.5%, 95% CI:19.6-34.4% vs 23.8%, 95% CI:17.2-31.5%); p=0.541). Integrated WATS and RFB (49/147) significantly improved detection of HGD/EACs vs RFB alone (33.3%, 95% CI:25.8-41.6%; p< 0.001). The mean procedural time for RFB alone, WATS alone and integrated WATS and RFB were 6.4 (95% CI:5.8-7.2; median, 5.0; IQR,4-8) minutes, 4.8 (95% CI:4.1-5.5; median, 5.0; IQR, 3-6) minutes and 11.2 (95% CI:10.5-11.9; median, 10; IQR, 8-14) minutes, respectively.

    Conclusions In an enriched population with known dysplasia, WATS and RFB detected similar number of cases with HGD/EAC. However, the combination of the two techniques significantly improved detection of HGD/EAC compared to RFB alone, confirming the role of WATS as an adjunct to RFB.


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